Understanding and Preventing Complications

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As technology and surgical techniques have improved, complications once associated with open-heart surgery have become less common. However, every surgical procedure has some risk. Though rare, potential complications include infection, bleeding, stroke or heart attack.

Understanding how to prevent complications and recognize early signs will help to reduce these risks.

Incision Care

It is normal to have some discomfort, bruising, numbness, swelling and itching at your incision site for several weeks after the surgery. Be sure to follow the instructions from your doctor or nurse for proper incision care.

A shower or gentle washing of the incision site is usually recommended. Tub baths are typically not allowed because they can affect your circulation. To help prevent infection, avoid using creams or lotions around the incision site until otherwise directed by your doctor.

The wires holding your sternum together are permanent. Dissolvable stitches will usually disappear within one to three weeks but can remain up to six weeks, depending on the type of stitches you have.

Fluid Retention

After surgery, some people experience fluid retention that can overload the heart and make it work inefficiently. To prevent fluid retention, your physician may recommend dietary changes and/or medications.

You can help monitor this at home by weighing yourself every morning. Report any sudden weight gain of three pounds or more in one day, or five pounds or more in one week. You should also contact your doctor if you experience unusual shortness of breath or swelling of your hands, ankles or stomach.


Bacteria can enter the bloodstream during dental and some surgical procedures and cause an infection known as bacterial endocarditis in the tissue surrounding the artificial heart valve. Although this occurs infrequently, you should consult your doctor before you have any dental or surgical procedure so antibiotics can prescribed. Also, be sure to tell your dentist and any other doctors that you have had heart valve surgery.


If you receive a mechanical heart valve, your doctor may prescribe an anticoagulant medication (blood thinner) to prevent blood clots from forming on or around the new valve. Your doctor will determine the level of anticoagulant that is right for you and closely monitor the levels with blood tests. You will need to take your medication as prescribed and follow up with blood tests as scheduled.

Food, alcohol and other medications, including over-the-counter products, can affect your anticoagulation level. Follow your doctor’s recommendations to maintain healthy anticoagulation levels.

Notify your dentist, oral surgeon or doctor that you are on an anticoagulant before having any dental or medical procedures. Adjustments may need to be made to your medication prior to any procedure.

When taking anticoagulant medication, consult your doctor if any of the following occur:

  • Excessive bruising
  • Excessive bleeding
  • Blood in your urine
  • Bloody or black, tarry stool
  • Unusual nosebleeds
  • Bleeding gums
  • Pregnancy or trying to become pregnant 
  • Fever or other illnesses that, include vomiting, diarrhea or infection

In general, contact your doctor if you develop any of the following symptoms:

  • Redness or drainage of your incision
  • Shortness of breath
  • Swelling of your feet or ankles
  • Chest, jaw, shoulder or arm pain
  • Bruising
  • Excessive bleeding
  • Blood in your urine
  • Bloody or black, tarry stool
  • Unusual nose bleeds
  • Fever
  • Numbness or tingling in your arms or legs
  • General weakness or loss of energy
  • Blurred or loss of vision
  • Unusual chest sensation

Follow-up Care 

After your heart valve surgery, it will be important for you to adhere to your doctor’s orders and go to your follow-up appointments as recommended. As always, ask your doctor if you have any questions about potential risks or if you have more questions about heart valve repair.